HomeMy WebLinkAbout20100865 Ver 1_401 Application_20101010r-
2010086,15
The following is an abbreviated application form for those applying for a 401 Water Quality
Certification to impact FERC (Federal Energy Regulatory Commission) regulated lake shore or
bottom under the U.S. Army Corps of Engineers Permit GP30. This Application cannot be used
for wetland or stream impacts. Please provide five (5) copies of this application and supporting
information as well as a non-refundable application fee to the Division of Water Quality of $240.00
for impacts to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater or
equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 OversightlExpress Review Permitting
1650 Mail Service Center
Ral ' NC 2'76991650
1Q
'? I ? t1 lv
I. Applicant Information Stub
1" W
OwnedApplicant Information
Name:
Mailing Address:
Telephone Number: .? 7 79- .7 Fax Number. YZr--1r? `7 -2-37
E-mail Address: e14 rID P 0 Z CI 115 I'mo' Y-4 r I e-
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number Fax Number.
E-mail Address: - - - --- -- --- SrRO
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local landmarks such
as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and
development plans in relation to surrounding properties. You may use the diagram below to make a
hand sketch of your project. Also, see the example below for guidance. Both the vicinity map and site
plan must include a scale and north arrow. The footprints of all buildings, impervious surfaces, or other
facilities must be included.
a
?r yam[ ?J
,.. f?t ryM1 'r ??e
:? ?ewyav
1. Location
County: ?Prt F ? s r i? Nearest Town: -ra 7C e d e
r site address (include phaseliot number):
i
Directions to site please include road numbers, landmarks, etc. (This is not necessary if/?an adequate 1
vicinity map is included): \? ? ?d -?L! It Zra .) W 1?+e I - A&
41
?r 1 vp ?P_xa-r 4 4,. !mac / k 5 . -r,)-,. /P4* -ET'A- ?-.a, -? Av h hv .2pol / A h ro //
i-n6i,/v2 It ' (SCR 7' e ?w e Psi Ao K5'p a X&q-Ae-use
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): /0 &/7 ao* S
4. Nearest body of water (stream/river/sound/ocean/lake): S n+11 r
5.
Describe the purpose of the proposed work:
e
P
C
,foil,
6. List the type of equipment to be used to construct the projects /trba C--k--Ito ep
7. Amount of impact (including all excavation, backfill, rip rap, retaining wails, etc.) below the
normal pool lake level in square feet or acres: j ?ee -t `tiff l(??' /1 G? Sc
,fie/a1f,- LaAe let-p- It
8.a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
above the normal pool lake level and 50 feet land-ward in square feet or 7,:
?r? s
I- L
,
4e 70 d ",
Please describe vegetation above the normal pool lake level
(number of trees for instance): 1 `iCpy p /4 h 7 [?c
50 feet landward to be impacted
Applicant/Agent's Signature Date t
(Agent's signature is valid only if and jauthorization letter from the applicant is provided.)
e-i r
S
1 Y ? I"
i
d
t
O i rt
ro
`gt
C k-V 5 o..
' 6 b
"•.
r '? !',
vfvf
r
DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project site can have a big
impact on permit processing time. Please complete this form and return it along with your completed permit
application to:
DUKE ENERGY
C/O LAKE SERVICES - EC 12 Q
PO BOX 1006
CHARLOTTE, NC 28201-1006
1-800-443-5193 and select Option 5
Applicant's Name:
Street Address (/at lake): S ?n /.,1c Z,?
n
Lake Name: L a l ? 1.?
Subdivision Name:
Tax Parcel ID (if known): q C-- L-It 4( q0 19
City S' l?tE? a County.
State: ?- Zip: 7
7 3
Latitude. Longitude: Se e c?
Telephone:
Directions (from major road or highway): Ta 2 '/o S1111-//1 , La ?? SKI nom, ?-
yQ Da),
? u r ? o S <<t ,??' Sq •? ? , '? 1? d 2-?/'. ??? t° l«t f /? ? : Q ? r l P S
? L'CPAr? ?'? (c?iiE 7C'%1//?> ?rn?/2 , %u/1 t1 l P 'jf :H7?o t?Q?iv2fe fe 7.?6t?CC1
^('T. EL A0 i n
S t? e e
/` -
t
re S C?c?7iv ?Fpcl
Descripti ve Structures `i c- u
() on Property (i.e- brick garage, white fence mobile home, et
/J
?Gl „S' ?t C 11 4 ?t t, f-,eC-i,,,\ - , 4 roe t
EC12-Q
P O BOX 1006
CHARLOTTE, NC 28201-1006
704-382-1567 or TOLL FREE 1-800443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in blank PLEASE
SUBMIT APPLICATION AND APPROPRIATE DUKE ENERGY FILING FEE, PAYABLE TO D ENERGY,
TO ABOVE ADDRESS. 3G'G'
1. Applicant Information /J
A. Name i
B. Mailing Address--.J.621 LJQ c-- ?th E'
C. Telephone: 7
U. Location of Proposed Project
A. Lake Sa *t,6x r
B. Street Address
C. County f5Oti
D. City, town, community or landmark L, :
E. Section Lot # Subdivision
F. Directions to property by road 'Tg/f P ,ZoZ ,? S0,? la k e h« r G. Latitude and longitude for the project site - ?-- ' Pla
H. Please submit a map showing the coordinates or a detailed map (U GS quad map, city map, etc.) showing the
exact location of the project site. (NOTE: Latitude/ longitude coordinates can be found on internet site,
www.mai)sonus.com. Directions: Don't register, click "Maps", enter address, draw map, select "Map Clicking
Will...", select "Lat/Long", click map)
III. Description of Project n
A. Length of wall 36? `f f
B. Material n c k
'
C. Distance from property lineJshoreline A 1'h q
?? ( e
IV. Intended Use of Project Area
/ D
A. Private -&
i?t7 e /? ESQ ?n
B. Commercial
V. Applicant Signature, Date
PLEASE NOTE THE FOLLOWING:
• 2 COPIES OF THE "DUKE ENERGY APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA", PHOTOGRAPHS OF THE SHORELINE TO BE STABILIZED, AND FIVE (5) COPIES OF THE
COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION'
MUST BE SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO:
NC DIVISION OF WATER QUALITY
ATTENTION.- CYNDI KAROLY
PARKVIEW BLDG., 2321 CRABTREE BLVD.
RALEIGH, NC 27604
919-733-1786
Y:\LAUMGMTftdmV Infww iw\NC Shotdine Stabilization Application.dm
fi°:?`7i?? ;c£:;. 'e ^?€•. •` ?"x"wry ?
lot,
ai -
;a `
$ 4
R$? .3
44
y, '
t IL
? aG ? r :.i
in ?l
r 4th " 1 '
x ,?#ypm,. t Srft
y K +?
1 }
AV,
. _:
r _
_ =t
Y
9
? x da
I.
? y
tj,
U
N
O
O O
O O
3
:ell
n D
a
c o
X
0 m
a O
r? N
X
M
ro
a ?
a
v
'o r
?rt
M a
? o
D
A
v
-{yn
V/
2
X
z
m
S
z
D
Z
n
r ?
o ?
N
U) r)
v of
m
z
O 0-
O
v L"
?Z
?o >1
%0 n
N ._
W Z
C
J
M
L
co ?
Ln
lfl
0
N
I
V a
V
IA
01
Z
In
0
c
3
a
Y'f
I ?l
3
m( 0
r 3
;•a ? I? O
I m,,?? Z
C YY/7
A \
o ?
+ of
I ? 3rt
1 0
A
t Z r
? k? ? n
CO
(D
, (A OD
I
rI I
_ I
i
I?
R O O
C
O
O
1
A
A
a
A
A
y
y
F
Iry??
-`l
• F
F
ti.
0
N r_
O
O r_
O
t
9 ?
k _
v 3 ?
1
j I rn
a
? a
M
0
' K
Imo`, ? -: tD
? C
. \ / L
r ?
u? 4y.
• n 'd c
n(
O(n
y
Q?V
F ? 111 ?
0 U13
°' A m O
Z i+
;En
v
. u? ? i 5a
i
rlo
o o
N
cT